CN105243273B - The parameter detecting of cardiac output waveform correlation - Google Patents

The parameter detecting of cardiac output waveform correlation Download PDF

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CN105243273B
CN105243273B CN201510627988.9A CN201510627988A CN105243273B CN 105243273 B CN105243273 B CN 105243273B CN 201510627988 A CN201510627988 A CN 201510627988A CN 105243273 B CN105243273 B CN 105243273B
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time point
point
cardiac cycle
cardiac output
output waveform
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CN105243273A (en
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F·哈迪布
L·D·罗特里克
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Edwards Lifesciences Corp
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7235—Details of waveform analysis
    • A61B5/7239—Details of waveform analysis using differentiation including higher order derivatives
    • A—HUMAN NECESSITIES
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    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/02028—Determining haemodynamic parameters not otherwise provided for, e.g. cardiac contractility or left ventricular ejection fraction
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/021—Measuring pressure in heart or blood vessels
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/024—Detecting, measuring or recording pulse rate or heart rate
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/026—Measuring blood flow
    • A61B5/029—Measuring or recording blood output from the heart, e.g. minute volume
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7235—Details of waveform analysis
    • A61B5/725—Details of waveform analysis using specific filters therefor, e.g. Kalman or adaptive filters

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Abstract

The method for describing the parameter for detecting cardiac output waveform correlation.This method includes the method for the individual cardiac cycle of detection cardiac output waveform correlation, detect the wrong method in the specified starting point of the individual cardiac cycle of cardiac output waveform correlation, wrong method in the method for detecting the dicrotic notch of the individual cardiac cycle of cardiac output waveform correlation, and the specified dicrotic notch of the individual cardiac cycle of detection cardiac output waveform correlation.Determine that these parameters are extremely important for clinician, because these parameters form the basis for calculating many other cardiac output relevant parameters.

Description

The parameter detecting of cardiac output waveform correlation
The application is the applying date on 2 11st, 2010, entitled " parameter detecting of cardiac output waveform correlation " The divisional application of state's patent application 201080016241.5.
Technical field
Background technology
Can be according to many parameters that cardiac output waveform correlation (such as Radinal pressure waveform) determines not only to disease Diagnosis is important, and i.e. continuously the clinically significant change of monitoring subject is all critically important to " real-time ".Various sides be present Method, these parameters are identified and/or calculate for the analysis of the various features based on cardiac output waveform correlation.Almost do not cure Institute does not monitor one or more than one cardiac output relevant parameter so as to provide the state of subject using these methods The equipment of the alarm of change.
The content of the invention
The method for describing the parameter for detecting cardiac output waveform correlation.It is related that this method includes detection cardiac output The method of the individual cardiac cycle of waveform, detect cardiac output waveform correlation the individual cardiac cycle specified starting point in mistake Method, detect cardiac output waveform the individual cardiac cycle dicrotic notch method, and detection cardiac output waveform correlation The individual cardiac cycle specified dicrotic notch in wrong method.
Detecting the method for the individual cardiac cycle of cardiac output waveform correlation includes providing cardiac output waveform correlation data With the single order derived function for calculating Wave data.Then the order of the data of single order derived function is inverted in time.Then single order is led For the amplitude of function compared with threshold value, the threshold value is the percentage of the peak swing of single order derived function.Then identify just in single order Single order leads letter after the amplitude of derived function is more than the point (i.e., on time before it) through the threshold value in reversing time alphabetic data Number is equal to zero for the first time, to determine the starting point of cardiac cycle.Single order derived function is equal to zero starting point for showing the cardiac cycle for the first time.
Detecting the wrong method of the specified starting point of the individual cardiac cycle of cardiac output waveform correlation includes providing individual The cardiac output waveform correlation data of cardiac cycle, the individual cardiac cycle has predetermined starting point, and determines cardiac output phase Close the maximum of Wave data.Then first point of cardiac output waveform correlation is determined, be related in cardiac output at this first point There is first point of the value for being equal to maximum half on waveform before maximum.Then the heart between starting point and is searched at first point The local maximum for cycle portions of fighting.If find local maximum, then search first point of heart between local maximum The local minimum point for cycle portions of fighting, and the starting point of individual heartbeat is re-designated as local minimum point.
Detecting the method for the dicrotic notch of the individual cardiac cycle of cardiac output waveform correlation includes providing individual heartbeat week The cardiac output waveform correlation data of phase, the individual cardiac cycle has previously determined start time point, and calculates waveform number According to single order derived function.First time point and the second time point are determined then according to single order derived function, the first time point is First zero crossing after the start time point of single order derived function, second time point are the initial times of single order derived function Second zero crossing after point.The second order derived function of Wave data is also calculated, and the 3rd time was determined according to second order derived function Put with the 4th time point, first zero crossing after the second time point that the 3rd time point is second order derived function is described Second zero crossing after the second time point that 4th time point was second order derived function.Then the 3rd time point and the 4th is searched The local maximum of second order derived function part between time point, the local maximum appeared in for the 5th time point.At the 5th Between point correspond to dicrotic notch and be located at time point at the cardiac output waveform correlation data of individual cardiac cycle.
Detecting the wrong method of the specified dicrotic notch of the individual cardiac cycle of cardiac output waveform correlation includes providing The cardiac output waveform correlation data of individual cardiac cycle, the individual cardiac cycle have the previously determined dicrotic notch time Point, previously determined start time point, previously determined cardiac output maximum of points and point of previously determined end time, and Calculate the single order derived function of Wave data.It is then determined that single order derived function cardiac output maximum of points and search time point between All local maximums, it is start time point plus the time between start time point and end time point to search time point 2/3rds.If find more than one local maximum, then dicrotic notch is designated as at second local maximum Time point.
Brief description of the drawings
Fig. 1 shows the stream for the example logic for illustrating the individual cardiac cycle for detecting cardiac output waveform correlation Cheng Tu.
Fig. 2A shows the arterial pressure waveform on record of several cardiac cycles.
Fig. 2 B show the single order derived function of arterial pressure waveform shown in Fig. 2A.
Fig. 3 shows to illustrate the example logic of the individual cardiac cycle number for examining cardiac output waveform correlation Flow chart.
Fig. 4 A-D show that the example of the cardiac output waveform of heart murmur occurs.
Fig. 5 shows to illustrate the mistake of the specified starting point of the individual cardiac cycle for detecting cardiac output waveform correlation Example logic flow chart.
Fig. 6 A show the arterial pressure waveform on record of several cardiac cycles, wherein wrong identification cardiac cycle Initial.
Fig. 6 B show the wrong application of the specified starting point of the individual cardiac cycle for detecting cardiac output waveform correlation The cardiac cycle reference point of method.
Fig. 7 shows to illustrate the logic of the dicrotic notch of the individual cardiac cycle for detecting cardiac output waveform correlation The flow chart of example.
Fig. 8 A show the arterial pressure waveform on record of several cardiac cycles.
Fig. 8 B show the single order derived function according to Fig. 8 A waveform.
Fig. 8 C show the second order derived function according to Fig. 8 A waveform.
Fig. 9 shows to illustrate in the specified dicrotic notch of the individual cardiac cycle for detecting cardiac output waveform correlation Wrong example logic flow chart.
Figure 10 A show the arterial pressure waveform on record of several cardiac cycles.
Figure 10 B show the single order derived function according to Figure 10 A waveform.
Figure 11 is the block diagram for showing to realize the critical piece of the system of approach described herein.
Embodiment
The method of the parameter for detecting cardiac output waveform correlation is described herein.Specifically, method described herein bag The individual cardiac cycle of detection cardiac output waveform correlation is included, the individual cardiac cycle of detection cardiac output waveform correlation specifies The mistake of starting point, the dicrotic notch of the individual cardiac cycle of cardiac output waveform correlation is detected, ripple related to detection cardiac output Mistake in the specified dicrotic notch of the individual cardiac cycle of shape.In addition to being important parameter for clinician, the heart Individual cardiac cycle and dicrotic notch in output quantity waveform correlation form the base for calculating many other cardiac output relevant parameters Plinth, therefore, initially identify that cardiac cycle and dicrotic notch form clinician and suitably provide treatment for subject exactly Basis.
As used herein, phrase cardiac output waveform correlation be used for show it is for example proportional to cardiac output, by The related signal of function that cardiac output obtains or cardiac output.The example of these signals includes but is not limited to periphery and moved Pulse pressure and central artery pressure and/or flow, pulse oximetry waveform, impedance plethysmographic waveform and doppler waveform.Term Peripheral arterial pressure is to represent that any point (such as radial artery, femoral artery or arteria brachialis) is with intrusion or non-intruding in arterial tree The pressure that mode measures.If using intrusive mood instrument, especially, the pressure sensor of conduit is installed, then any artery can To be possible measurement point.Placing non-invasive sensors will generally be itself indicated that by instrument, for example, finger band, upper arm pressure Power band and ear-lobe fixture.Measure the peripheral arterial pressure increase further away from heart.Either using specific instrument or Mensuration, the data of acquisition will finally produce the electric signal corresponding to cardiac output (for example, proportional to cardiac output).
The stream of method in Fig. 1 as disclosed herein for detecting the individual cardiac cycle of cardiac output waveform correlation Shown in journey figure, this method includes providing cardiac output waveform correlation data (10), calculates the single order derived function of Wave data simultaneously And the time sequencing (20) of reversal data.The amplitude and threshold value (30), the i.e. maximum of single order derived function for comparing single order derived function shake Width percentage.Single order derived function the is identified after the point for the threshold value that the amplitude of single order derived function is more than reversing time alphabetic data Once it is equal to zero, to determine the beginning (40) of cardiac cycle, i.e. single order derived function is equal to zero for showing the cardiac cycle for the first time Begin (50).
Fig. 2A is the example on the arterial pressure waveform of record of several cardiac cycles.The individual cardiac cycle is by close to waveform The point of minimum value shows.Include calculating single order using the method for being used to detect the individual cardiac cycle just described and lead letter Number, the single order derived function as waveform shown in Fig. 2A show (to notice that the single order when time sequencing inverts leads letter in fig. 2b Number is not shown in fig. 2b).Then compare single order derived function and threshold value, thick line is used in fig. 2b for the purpose threshold value of the example Show.Then, just (shown as after the amplitude of single order derived function is more than the point of threshold value before the time), position first Zero crossing.First zero crossing of the part of single order derived function is shown with dotted line in fig. 2b.For leading shown in Fig. 2 B Function, select the rising part of single order derived function peak value or the threshold crossings point of sloping portion do not interfere with before peak value the The identification of one zero crossing.The zero crossing moment of identification is (referring to from Fig. 2 B to Fig. 2A at the time of beginning the individual cardiac cycle Dotted arrow indicates).In order to calculate next cardiac cycle, the amplitude for searching single order derived function is more than the single order derived function of threshold value Next point, and repeat the process.This method can be repeated, until reach provide waveform terminal (or, if company Data are provided continuously for example to monitor in real time, then can ad infinitum be gone on).
Wave data can be filtered in order to remove high and low frequency noise before single order derived function waveform is calculated.Such as High-pass filter can be used for suppressing baseline drift and eliminate the breathing influence of subject.Filtered by using forward and reverse numeral Wave technology retains and input signal same phase, and high-pass filter is used together with method described herein can realize zero phase Distortion.Include what is removed baseline drift and breathe with another parameter for the high-pass filter that method described herein is used together Low frequency (e.g., 0.25Hz) cut-off frequency.For further example, low pass filter can be used for before first derivative is calculated Smooth waveform signal.Low pass filter can reduce any fast time-domain conversion of arterial pulse pressure signal and/or the influence of conversion. Finite impulse response filter can be used for limiting the time delay in low pass filter operation.Use low pass filter and high-pass filtering It is well-known to those skilled in the art that device, which contributes to the process performance of data,.
Detect cardiac output waveform correlation cardiac cycle in common problem encountered is that heart rate is irregular.This heart rate is irregular Example include but is not limited to premature atrial contraction or premature ventricular contraction, cardiac arrhythmia and auricular fibrillation occur.Heart rate is random Rule generally comprises Premature contracfion, and this can occur at any time.These Premature contracfions typically produce less than dominant beat Capacity and lower pressure.The low capacity and small pressure of these beatings cause to be occurred in the signal of all cardiac output waveform correlations Small beating.Small beating has and the diastolic phase in cardiac output waveform correlation as caused by too early heart contraction Or caused baroreflex similar amplitude and frequecy characteristic during the advanced cardiac contraction phase, this causes these beatings to be difficult to Distinguish baroreflex.For example, if relatively low threshold value is used to detect beating small as caused by too early heart contraction, then compared with Big baroreflex can mistakenly be treated as cardiac cycle.
In order to overcome the possibility that baroreflex is considered as to cardiac cycle, it is used to detect cardiac output correlation as described above The method of the individual cardiac cycle of waveform can repeat in different threshold levels, so as to examine the detected cardiac cycle Number.In order to examine the number (as shown in Figure 3) of cardiac cycle, as previously discussed, this method is performed using first threshold (10), this method (20) is then performed for the second time using second (relatively low) threshold value.Then, different threshold values are compared with to be detected Cardiac cycle number (30).If the cardiac cycle number using first threshold detection and the heartbeat using Second Threshold detection The ratio between number of cycles is less than 65%, but it is per minute be higher than 35% of 150 beating number no more than the beating per minute detected, that The actual number (40) of cardiac cycle as the cardiac cycle determined by the use of Second Threshold.If utilize first threshold detection The ratio between cardiac cycle number and cardiac cycle number for being detected using Second Threshold are less than 65% and per minute be higher than 150 and fight Dynamic number is more than the 35% of the beating per minute detected, then the cardiac cycle determined by the use of first threshold is used as the cardiac cycle Actual number (50).If the cardiac cycle number using first threshold detection and the cardiac cycle number using Second Threshold detection The ratio between mesh is not less than 65%, then the actual number (60) of cardiac cycle as the cardiac cycle determined by the use of Second Threshold.Profit It can repeat this method with extra paired first threshold and second (relatively low) threshold value.
Threshold value selection in method for detecting the individual cardiac cycle depends on various factors.With side as described herein The threshold value example that method is used together includes 0.8,0.75,0.7,0.65,0.6,0.55,0.5,0.45,0.4,0.35 and 0.3.With Threshold value and more Low threshold that these methods are used together include the various combinations of these threshold values to example, for example, 0.75 and 0.6 or 0.6 and 0.3.To that can be useful, this depends on actual conditions for other threshold values and threshold value.Fig. 4 A to 4D show the generation heart Restrain the example of uneven cardiac output waveform.Each waveform in these waveforms is represented according to the non-of cardiac output waveform correlation Heartbeat detection in the situation often challenged.This method is used for the beating shown in successfully detection point.Fig. 4 A-4D are shown non- The premium properties of this method in the situation often challenged.
Here also description is used for the individual cardiac cycle for detecting cardiac output waveform correlation (as shown in the flow chart in Fig. 5) Specified starting point wrong method.Starting point is specified to include cardiac arrhythmia situation or mistake aroused in interest by the example of the wrong situation specified Fast situation, wherein the diastolic phase in waveform occurs larger baroreflex, and next cardiac cycle previous The reflection of the diastolic phase of cardiac cycle is begun to before terminating.In such cases, the cardiac cycle start comprising figure Similar small peak value shown in 6A with Fig. 6 B.In the case of these types, standard beating detection method may be in previous week (the position where real starting point of beating before the small peak value of the minimum point of the diastolic phase of phase rather than after peak value Put) the just mistakenly beginning of detection heartbeat.The error detection of this pacemaker can cause true based on the waveform analyzed Apparent error in other fixed cardiac parameters.The wrong method of the specified starting point of individual cardiac cycle is detected (such as institute in Fig. 5 Show) include providing the cardiac output waveform correlation data (10) of the individual cardiac cycle with predetermined starting point.It is then determined that the heart is defeated The maximum (20) of output waveform correlation data and find first point (30).This first point is to have to be equal to before maximum First point on the cardiac output waveform correlation of the value of maximum half.Then the cardiac cycle between starting point and is searched at first point Partial local maximum (40).If find local maximum at first point between starting point and, then search first drawn game Between portion's maximum cardiac cycle part local minimum point (50), the starting point of individual heartbeat redesignated as it is local most Small value point (60).If between starting point and local maximum is not found at first point, then retain the current starting point (70) of heartbeat. This method may further include the starting point for finding next individual heartbeat, its also by be the current individual cardiac cycle end Point.
In order to further illustrate this method, Fig. 6 A show the waveform for the starting point for mistakenly detecting each cardiac cycle (referring to the point of local minimum).Fig. 6 B show the reference point of the cardiac cycle using this method, i.e. k is the cardiac cycle Predetermined starting point (k+1 is the starting point of next cardiac cycle), s is the maximum of cardiac output waveform correlation data, and h is in maximum There is first point on the cardiac output waveform correlation equal to the value of maximum half, l is between starting point and before value at first point Local maximum, d be using this method calculate cardiac cycle correct starting point.
Here the individual that (and showing in a flow chart in fig. 7) is used to detect cardiac output waveform correlation is further described The method of the dicrotic notch of cardiac cycle.The heart that this method includes individual cardiac cycle of the offer with previously determined starting point is defeated Output waveform correlation data (10), and calculate the single order derived function (20) of Wave data.Then is determined according to single order derived function One time point (first zero crossing after the start time point of single order derived function) and the second time point are (in single order derived function Start time point after second zero crossing) (30).Also calculate the second order derived function (40) of Wave data.Then according to two Rank derived function determines the 3rd time point (first zero crossing after the second time point of second order derived function) and the 4th time Point (second zero crossing after the second time point of second order derived function) (50).When then searching the 3rd time point and the 4th Between put between second order derived function part local maximum, the local maximum occur at the 5th time point (60).Finally, Five time points were designated as dicrotic notch.The function used in this method can be filtered as described above.
In order to further illustrate this method, Fig. 8 shows the cardiac output data analyzed using this method.Specifically, scheme 8A shows the waveform with three cardiac cycles (point at local minimum) indicated, Fig. 8 B show waveform shown in Fig. 8 A Single order derived function, Fig. 8 C show the second order derived function of waveform shown in Fig. 8 A.Fig. 8 A point 1 is the cardiac cycle analyzed Starting point, the dotted line 2 between Fig. 8 A and 8B show the start time point of the cardiac cycle in single order derived function, and also in single order Occur before the first time point (that is, first zero crossing after starting point) of derived function.Point 3 in Fig. 8 B shows that single order leads letter Several the second time points (that is, second zero crossing after start time point).Dotted line 4 shows that the second time point was converted to figure The position of second order derived function shown in 8C is so as to beginning look for (that is, the second time point in second order derived function at the 3rd time point First zero crossing afterwards), and the point 5 in Fig. 8 C was the 3rd time point.Point 6 in Fig. 8 C was the 4th time point (that is, two Second zero crossing after the second time point in rank derived function).Point 7 (i.e. the 5th time point) in Fig. 8 C was the 3rd time Local maximum between point and the second time point.Shown 5th time point is converted back in Fig. 8 A waveform, herein the time Point shows the position of dicrotic notch (shown in point 9).
Here additional description (and being shown in flow chart in fig.9) is used for the individual body-centered for detecting cardiac output waveform correlation The wrong method fought in the specified dicrotic notch in cycle.When in the signal occur around dicrotic notch opening position it is larger anti- During ejected wave, the mistake of these types is typically occurred in the detection of dicrotic notch.This method includes providing with previously determined Dicrotic notch time point, previously determined start time point, previously determined cardiac output maximum and previously determined end The cardiac output waveform correlation data (10) of the individual cardiac cycle at time point, and calculate the single order derived function of Wave data (20).Then, it is determined that the cardiac output maximum of points in single order derived function and all local maximums between lookup time point (30).It is three of the time interval by being added between start time point and start time point and end time point to search time point / bis- determinations.If find more than one local maximum, then dicrotic notch redesignated as second part most The time point (40) being worth greatly.If only find a local maximum, then dicrotic notch is still that previously determined dicrotic pulse is cut Mark (50).
In order to further illustrate this method, Figure 10 shows the cardiac output data using this method analysis.Specifically, scheme 10A shows the waveform with about three cardiac cycles (and being probably two local minimums of dicrotic notch), and Figure 10 B are shown The single order derived function of waveform shown in Figure 10 A.Figure 10 A point 10 is the starting point for the cardiac cycle analyzed, Figure 10 A and figure Dotted line 20 between 10B shows the start time point of analysis single order derived function.Dotted line 30 shows lookup point, and it is starting point and end 2/3rds of the time interval between 40 are put, therefore the period between dotted line 20 and dotted line 50 shows to lead for finding single order The lookup window of the local maximum of function.Two local minimum M are found in window is searched1And M2.Because find more than one Individual local maximum, so dicrotic notch is designated as second local minimum M2, its point 60 corresponded in Figure 10 A.
Figure 11 shows the critical piece that can be used for implementing the system of method described herein, and methods described is used to detect the heart The individual cardiac cycle of output quantity waveform correlation, detect cardiac output waveform correlation the individual cardiac cycle specified starting point in Mistake, detect the dicrotic notch of the individual cardiac cycle of cardiac output waveform correlation and the individual of detection cardiac output waveform correlation Mistake in the specified dicrotic notch of cardiac cycle.This method can be implemented in existing patient monitoring device, or can make Implement for special monitor.As described above, cardiac output waveform correlation, or it is proportional to cardiac output, exported from the heart Other some signals of function that amount obtains or cardiac output can be with one of following two ways or simultaneously with two kinds of sides Formula senses：Intrusively and non-invasively.For convenience's sake, system is described as measuring arterial blood.
In order to which integrality Figure 11 also show two kinds of pressure-sensing.Described method is most of herein In practical application, it will typically implement a kind of change or several changes.It is conventional herein in the invasive application of described method Pressure sensor 100 is installed on conduit 110, and conduit 110 is inserted into the dynamic of a body part 130 for patient or infected animal In arteries and veins 120.Artery 120 is any artery in arterial system, such as femoral artery, radial artery or arteria brachialis.It is described herein Method Noninvasive application in, conventional pressure sensor 200 (such as, photo-plethysmographic blood pressure detector) is with any tradition Mode it is mounted externally, such as utilize the band around finger piece 230 or the sensor in patient's wrist.Figure 11 shows Meaning property it also show both types.
By signal of any of connector transmission from sensor 100,200, as the defeated of processing system 300 Enter, processing system 300 includes one or more than one processor and others support hardware and what is generally included is used to handle Signal and the system software (not shown) for performing code.Method described herein can utilize changing, standard, individual calculus Machine is implemented, or is incorporated to bigger, special monitoring system.In order that with method as described herein, processing system 300 is also It can include or be connected to regulation circuit 302, the regulation circuit 302 performs normal signal processing task on demand, such as amplify, Filtering or classification.Then by common analog-digital converter ADC 304, input pressure signal P (t) quilts detected being adjusted Digital form is converted to, ADC 304 has or using the time reference from clock circuit 305.It is well known that should be on Nyquist (Nyquist) criterions select ADC 304 sample frequency, to avoid effect distortion (mistake of pressure signal Journey is very famous in digital processing field).Output from ADC 304 will be discrete pressure signal P (k), its Value can be stored in Conventional memory circuitry (not shown).
It can be held by the computer comprising one side or more than one aspect for performing method as described herein The software module 310 of line code, value P (k) can be transferred to memory or be accessed from memory.Software module 310 this Kind design is flat-footed for the technical staff in computer programming field.Extra comparison used in method and/or Processing can perform in extra module (such as 320 and 330).
If used, such as previously determined dicrotic notch time point, previously determined start time point and previously determined The specific data of signal of end time point etc. can be stored in memory area 315, it can also store other on demand Predefined parameter.These values can input in a usual manner by using any of input equipment 400.
As shown in figure 11, as a result it is eventually displayed on conventional display or recording equipment 500, is presented to user and by user Interpretation.As input equipment 400, display 500 is generally equally used by processing system, to other purposes.
Above the present invention is described by reference to the block diagram and flowchart illustration of method, apparatus and computer program product Exemplary embodiment.It will be apparent to one skilled in the art that each module of block diagram and flowchart illustration and block diagram and The block combiner of flowchart illustration can be performed by the various devices including computer program instructions respectively.These computers Programmed instruction can be loaded into all-purpose computer, special-purpose computer or other programmable data processing units, with manufacture machine, therefore The instruction performed on computer or other programmable data processing units is produced for performing in flow chart modules or multiple moulds The method for the function of being specified in block.
Method described herein further to the computer program instructions that can be stored in computer-readable memory, It can indicate other programmable datas processing of computer or such as processor or processing system (as shown in 300 in Figure 11) Device functions in a particular manner, and includes being used for so that the instruction being stored in computer-readable memory produces one kind Perform the manufacture product of the computer-readable instruction for the function of being specified in the module in Figure 11.Computer program instructions can load Into computer, processing system 300 or other programmable data processing units, so that series of operation steps is calculating Performed in machine, processing system 300 or other programmable devices to produce computer implementation procedure, thus computer or other can The step of instruction performed in programmer provides the function of being used in execution module specifying.Moreover, for performing various calculating It can also be can perform with the various software modules 310,320 and 330 for performing correlation technique step described herein as computer Instruction is stored on a computer-readable medium, to allow method to be loaded into different processing systems and by different processing systems Unite to perform.
Therefore, square frame module and flowchart illustration support the combination of the device for performing specified function, for performing The combination for the step of specifying function, the program instruction means for performing specified function.It is it will be apparent to one skilled in the art that logical The combination for performing the hardware based dedicated computer system or specialized hardware and computer instruction of specifying function or step is crossed, can To implement the combination of the module in each module and block diagram and flowchart illustration of block diagram and flowchart illustration.
The present invention is not limited to the category of the embodiment of the explanation of some aspects disclosed herein as the present invention, and And it is any embodiment of function equivalent all in scope of the invention.Except those show with method as described herein with Outside, the improvement of various methods is it will be evident that and falling into the category of accompanying claims for a person skilled in the art.Enter One step, although only specifically discuss some typical combinations of method and step disclosed herein, method in the above embodiments Other combinations of step are it will be evident that and falling into the category of accompanying claims for a person skilled in the art.Therefore, Here it is clearly directed to the combination of step；However, although not clearly stating, also other combinations including step.Used here as Term "comprising" and its variant use synonymous with term " comprising " and its variant, and be all open, unrestricted term.

Claims (5)

1. a kind of wrong method in specified starting point for the individual cardiac cycle for detecting cardiac output waveform correlation, it is included：
The cardiac output waveform correlation data of individual cardiac cycle are provided, the individual cardiac cycle, which has, specifies starting point；
Determine the maximum of the cardiac output waveform correlation data；
Determine first point in the cardiac output waveform correlation, described first point be on the cardiac output waveform correlation There is first point of the value equal to the maximum half before the maximum；
Search the starting point and it is described first point between cardiac cycle part local maximum；
Wherein, if finding local maximum, then search first point of cardiac cycle between the local maximum Partial local minimum point, and the starting point of the individual heartbeat is re-designated as the local minimum point.
2. according to the method for claim 1, further comprising the starting point for finding next individual heartbeat, wherein described next The starting point that each and every one body-centered is fought is the terminal of current individual cardiac cycle.
3. a kind of method of the dicrotic notch for the individual cardiac cycle for detecting cardiac output waveform correlation, it is included：
The cardiac output waveform correlation data of individual cardiac cycle are provided, the individual cardiac cycle has previously determined starting Time point；
Calculate the single order derived function of the Wave data；
First time point and the second time point are determined according to the single order derived function, the first time point is that the single order leads letter First zero crossing after several start time points, and second time point is the described of the single order derived function Second zero crossing after start time point；
Calculate the second order derived function of the Wave data；
3rd time point and the 4th time point are determined according to the second order derived function, the 3rd time point is that the second order leads letter First zero crossing after several second time points, the 4th time point are described the second of the second order derived function Second zero crossing after time point；With
Search the local maximum of the second order derived function part between the 3rd time point and the 4th time point, institute State local maximum and appeared in for the 5th time point,
Wherein, the 5th time point corresponds to the cardiac output waveform correlation number that dicrotic notch is located at the individual cardiac cycle According to the time point at place.
4. according to the method for claim 3, further include and filter the second order derived function using low pass filter.
5. a kind of wrong method of the previously determined dicrotic notch for the individual cardiac cycle for detecting cardiac output waveform correlation, It is included：
The cardiac output waveform correlation data of individual cardiac cycle are provided, the individual cardiac cycle has previously determined dicrotic pulse Incisura time point, previously determined start time point, previously determined cardiac output maximum of points and it is previously determined at the end of Between point；
Calculate the single order derived function of the Wave data；
Determine all local maximums searched between time point in the cardiac output maximum of points and single order derived function, institute State search that time point is time between start time point and the start time point and end time point 2/3rds The sum being added,
Wherein, if finding more than one local maximum, then dicrotic notch is designated as at second local maximum Time point.
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